Applies to: Surgical Counselors, Front Office Lead, Clinic Leads, Billing Lead
 
On all elective cases, we need to get payment up front.  There are simply too many scenarios in which, when this does not happen, one of two things result:
 

1. We spend an inordinate amount of time pursuing the payment;
2. We do not get paid.

 
Therefore  do not make payment plans on the day of surgery because monies may not collected. It is a key responsibility of the each of the Counselors to explain that their (estimated) copayments, co-insurance, deductibles, and other amounts due for surgery (FEC and ASC) must be paid in advance of surgery.  The Counselors also need to explain that if the payments due in advance of surgery are not made, unfortunately, their procedure will be cancelled. This is especially important with regard to patients having DSEK and Transplants (PKs).
 
We should not be ordering corneal tissue – which costs ~ $4600 – until the Counselor confirms that any copayments, co-insurance, deductibles, and other amounts due for surgery (FEC and ASC) have been paid in advance of surgery.
 
All such scenarios – concerns/issues related to payment must be brought to the attention of the CEO, Billing Supervisor, ASC DON and Scheduling Supervisor.
 
Patients are not to pay for premium IOLs, LRIs, copayments, deductible, co-insurance and other patient financial responsibilities on the day of surgery,  these monies are to be collected in advance of the day of surgery.  Some people may not be prepared to make payment at the time of pretesting/Counseling, but they could do so at any time in advance of surgery.
 
Some patients who may not feel comfortable providing you with credit card information over the phone.  They can drop a check off in advance of surgery or pay by credit or debit card in person if this makes them more comfortable.  They can also pay via our patient portal.  (If you have questions regarding this, ask the Billing Supervisor).
 
This should be explained to patients at the time of pretesting to ensure that the payments we need to receive are, in fact received prior to surgery.

Applies to: Clinical; Billing; Clinic Supervisors, Front Office Leads
 
Clinical Assistants and Billing Staff – Please note that the “Impressions”(Diagnosis) listed in the chart notes must correspond with the Diagnosis’ listed in the Operative Report for all procedures, including injections, of course.
 
If you are the Assistant for a procedure and you see that this is not the case, please immediately bring this to the attention of the physician so that he can correct it; if you are a member of the billing department and see this in the course of your duties, please request a review or an addendum of the note by the rendering physician and copy the Billing Lead, Clinic Leads, Scheduling Lead and CEO.

If the 377.14 code is being utilized used incorrectly as it relates to certain VEP and/or pERG tests Dr. Vaishnav should be emailed, copying the CEO, Medical Records Lead, Clinic Leads,  and the assistant who did not use the correct diagnosis.
 
In a polite way, in your email, point out to the assistant that X is the correct diagnosis code and if there is any question about it, while Dr. Vaishnav is still in the room, please confirm this with him.

From: Jerry Orloff
Sent: Wednesday, July 22, 2015 8:11 AM
 
In the case of a cataract surgery please speak with me, or in my absence, contact Louise.  Please do not authorize payment arrangements in the absence of approval from one of us.

Effective immediately the process for securing money collected should be as follows:

• Melbourne office – Front desk person should balance and close their batch; all monies collected for the day in each drawer should be sealed in an envelope, with the staff member whose drawer it is having first counted the money, then signing and dating the envelope over the back seal of the envelope prior to taping over the signature to fully seal the envelope.With this done and the cash enclosed verified, the envelope should be placed in the lock box located in Michele Sacco’s office.
  
  
• Palm Bay and Rockledge offices – Front desk person should balance and close their batch;all monies collected for the day in each drawer should be sealed in an envelope, with the staff member whose drawer it is having first counted the money, then signing and dating the envelope over the back seal of the envelope prior to taping over the signature to fully seal the envelope.The envelope should not be sealed until the monies contained therein have also been counted by the staff member taking the charts to Melbourne.Once this has been done both the staff member whose drawer contents have been placed in the envelope, as well as the transporter should sign and date the envelope over the back seal of the envelope prior to taping over the signature to fully seal the envelope.Once the envelope has been transported to Melbourne the transporter is to place the envelope in the lock box located in Michele Sacco’s office.

Applies to: Jason K. Darlington, M.D.; Anterior Segment Assistants; Billing, Marketing, Front Office Leads; Clinical Leads

In order that billing be correct, and in order for us to be in compliance, the following steps must be taken in all cases and without exception.
 
In order that YAG Cap procedures that are to be co-managed get filed appropriately from the start, three items need to be addressed:
 

1. The record needs to be appropriately documented under PLAN that the patient is to be co-managed.  Be specific in your note.  Example:   “Patient to see Dr. Lawrence Thomas for PO care and be co-managed at Optique Unique.”
2. The Superbill needs to be noted – “COMANAGED – 54 – Dr. L. Thomas.”
3. The usual co-management paperwork should be signed – both by the surgeon and the co-managing doctor, as well as the patient.   If the patient does not arrive with co-management paperwork from the referring/co-managing doctor,  this paperwork should be available in the exam rooms and signed by the surgeon and patient.  This should be placed in the outguide.  When it gets to billing, it should get to Louise to ensure that the document is countersigned by the co-managing doctor.  This paperwork must be kept on file.
4. If at checkout, the Superbill is noted that the patient is to be co-managed but there is no paperwork in the outguide, this must be brought back to the surgeon to be addressed by check out or the front desk supervisor.  (Front desk supervisors – review this carefully with all checkout staff.).
5. Clinical Supervisors – be certain that all assistants are fully clear as to their role and responsibilities relating to this matter.

Applies to: Doctors, Assistants, Clinic Supervisors, Billing, Front Office
 
Please see the information below.  It shows where the "Residence" listing is noted under the "Social History" Section in Medflow.  (This is where you would note if the patient resides in a private residence vs. a nursing home, an assisted living facility or a rehabilitation facility).
 
This is of great importance as due to the "consolidated billing" rules, if we do not determine if a patient resides in a nursing home, an assisted living facility or a rehabilitation facility, prior to initiating care and we do not contact that facility first to authorize payment we will not receive payment, even if the patient has a valid Medicare card.  (If payment is made, it will likely be recouped within three months).
 
All Assistants must double check this at all visits - we cannot assume that by looking at someone and seeing that they appear relatively healthy that residency in one of these types of facilities is not a possibility.  The consolidated billing issue becomes a factor even for very short/temporary stays.
 
If you find that a patient resides in such a facility, immediately contact the Billing Lead so that she may obtain authorization prior to initiating care.  If you have difficulty getting ahold of someone in billing me and I will facilitate this .

Sent: Thursday, April 4, 2013 4:58 PM
Subject: RE: Nursing Home/Rehab/Assisted Living Tab in Allscripts
 
Please see the updated attachment.  This shows where in Medflow this information will be entered and accessed. 
 
Unfortunately, we are unable to edit section headings in ROS, but I was able to add a “Residence” section in Social History (right next door to ROS and Family History J )

Applies to:  All Employees
 
Employees must sign a document stating that they authorize payroll deduction of any unpaid charges if they do not pay for the services in full at the time services are rendered.  This should be signed BEFORE they receive services or products so that HR can deduct any remaining balances from their final pay if they should leave our employment.  In addition, optical products should be paid in full before the employee receives the item.
 
Scheduling of appointments for employees or their families must be scheduled or approved by HR prior to the appointment being made.